This is primarily a food diary that allows you to track macros, micros and calorie counts. You can also use it to look up carbohydrate values. It is useful because the database of food it has is huge. If you mainly eat unprocessed, home-made food it will require more work, but you can enter recipes and it will give you a calorie/carb count for them. Ignore the silly numbers (1,200 calories!) they suggest and customise your numbers to suit.

Created especially for diabetics (and run by them too), this app allows you to log blood sugar levels, how much insulin you take, exercise, how you feel and more. I use it intermittently as inputting all the information can get tedious. If you forget to log for a day or so, it’s difficult to remember. Some blood testing meters can be connected, which would make logging easier.

Thanks to mysugr, I worked out how to fine tune how much insulin I need to cover food (it varies depending on the time of day) and the best time for me to take my bolus insulin.

Pacer is a pedometer. My main form of exercise is walking and it’s great to know that I can achieve the recommended 10,000 steps relatively easily. It also tells you the distance you walk or run every day and you can use it to see weight loss goals. Be warned: this app drains your battery quickly.

All the above apps are free – though you can upgrade to premium versions. The free versions give enough information for this not to be necessary.

If you are in the slightest OCD, an app will encourage such behaviour so check yourself if you get uptight when you’re in an area where there no coverage or wi-fi… When that absence is too upsetting, step away from the app for a while.

NICE have released their new guidelines for type one adults. This paper was given some prominence in September’s BMJ as well as other papers that could be of interest to diabetics, their carers and health professionals.

In many respects the adult guidelines are similar to the children’s guidelines. Structured education gets support as does advice to aim for a hba1c of 6.5% (48) or lower provided hypos can be minimised. Of course this is virtually impossible if a high carb diet is followed but is much easier if the low carb dietary advice and precision meal to insulin matching as we describe in our book is done.

Levemir twice a day is the recommended basal insulin for all new patients and Lantus is advised only for those who refuse to use a twice daily bolus or perhaps need assistance from others for injection. We know that Lantus has some gaps in coverage as a 24 hour insulin and that it is less stable in heat and light than Levemir. It also stings on injection. Levemir also gives fewer hypos. Of course if someone is happy with Lantus, they can stay on it.

Life expectancy for type ones is currently 13 years less than for people without the condition. Fewer than 30% of adults achieve a hba1c of 7.5% or less.

Although the Cochrane collaboration noted a small degree of success with a low glycaemic diet strategy for type twos, this was not seen in the research that NICE looked at for type ones and therefore they don’t recommend low glycaemic as a dietary strategy.

Blood sugar targets are suggested to be ideally 5-7 first thing in the morning, 4-7 before meals and 5-9 at least 90 minutes after meals. Adults are advised that 4-10 blood sugar tests may be required each day. Before each meal and before bedtime are minimum testing times.

NICE want type ones to stick to their finger tips for blood sugar testing. This is the most accurate as hypos can be missed if other parts of the upper limb are used.

It is recommended that hypos are evaluated at least annually by a scoring system. The idea is to seek out those people for whom these are a problem and then fix it. NICE say this should not involve simply raising blood sugar targets. The obvious thing is to match insulin to meals, activity and basal needs more closely. If structured education around this appears to fail then the person should be considered for pump therapy and real time glucose monitoring.

Meal insulin boluses are recommended before meals. After meals is a strategy that works for toddlers but adults are expected to be able to adjust their insulin to meals and that means that they must be able to carb count.

So what can we expect from the implementation of these guidelines? There is still no clarity over diet and exactly how patients will get near normal blood sugars just by carb counting without actually restricting the amount they consume isn’t explained. There certainly will be a lot more adults who could be considered for pumps. But these are relatively expensive and require a lot of training. Setting strict blood sugar targets and hoping that technology will solve the problem has been going on for decades now. Why should it work now? NICE admits it hasn’t worked so far with more than 70% of type one adults having wildly high blood sugars. I would have been very interested to know what percentage of adults with diabetes achieved the target blood sugars of 6.5% or 48.

NICE do admit that to implement their proposals the medical workforce will need to be sufficiently trained to deliver the structured education and to help individual diabetics with their problems.

It’s all very well embarking on a low-carb diet, but how do you work out how many carbs are in the food you eat?

Here at the Diabetes Diet we encourage people to cook for themselves as it’s the best way to eat a good diet, but home cooking comes without the handy labels you get on ready-made food complete with their nutritional breakdown.

Meat, fish, eggs, cheese, nuts and fat have few or no carbohydrates, but vegetables and seasonings and ingredients used for thickening stews and sauces do have carbs. If you made a chilli con carne, for example, there would be carbohydrates in that from the onions, tomato sauce and kidney beans.

Myfitnesspal recipe calculations. Click on image to expand.

One easy way to work out carbohydrates in the dishes you make is to use a carb and calorie counting app or website. One example is myfitnesspal, where you can enter your recipes and the app will give you a nutritional break-down of what’s in your recipe – calories, carbs, protein content, fibre content and fat content.

If you don’t want to use an online tool, you can also use resources such as the Collins Gem carb counter. Bear in mind, for both ideas you’ll need to be weighing and measuring everything going into your recipe.

It does sound obvious, but many people have recipes and dishes they make where they don’t bother weighing or measuring anything simply because it is a dish they have been making for years. I prefer digital scales for their exact measurements and because you can weigh food in bowls or saucepans by setting the scale to nil.

If you have set a daily carbohydrate limit for yourself (we explore carbohydrate limits in the Diabetes Diet and what limits are suitable for different people, according to their health goals), then it is probably easiest to take that total and divide up by your meals.

In theory, if you were on a limit of 50-60g, then that equates to roughly 20g a meal, but you might want to stick to very low carbohydrate breakfasts and lunches and keep back a bit more for dinner.

And vice versa of course. You need to find a way of eating that you like, that fits in with your life and that you can keep up.